Evidence map›Paper›PMID 29067582›Full record

ArticleSurgical endoscopy2018

Growth in robotic-assisted procedures is from conversion of laparoscopic procedures and not from open surgeons' conversion: a study of trends and costs.

Priscila R Armijo, Spyridon Pagkratis, Eugene Boilesen, Tiffany Tanner, Dmitry Oleynikov

Abstract readEvaluation Study
PubMed Publisher
In one paragraph

Article in Surgical endoscopy, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers.

0numbers the graph read from it
0cells of the map it votes in
41citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

41 citing papers in PubMed.

  1. Trial
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  7. Rates of Minimally Invasive Surgery After Introduction of Robotic-Assisted Surgery for Common General Surgery Operations.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2025
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  8. Article
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  14. Robotic surgery training.Sao Paulo medical journal = Revista paulista de medicina · 2023
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  16. Article
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  18. Review
  19. Education in Robotic Hernia Surgery-Current Situation.Journal of abdominal wall surgery : JAWS · 2023
    Article
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Priscila R ArmijoCenter for Advanced Surgical Technology, University of Nebraska Medical Center, 986245 Nebraska Medical Center, Omaha, NE, 68198-6246, USA.
Spyridon PagkratisDepartment of Surgery, University of Nebraska Medical Center, 986245 Nebraska Medical Center, Omaha, NE, 68198-6246, USA.
Eugene BoilesenCollege of Public Health, University of Nebraska Medical Center, 984355 Nebraska Medical Center, Omaha, NE, 68198-4355, USA.
Tiffany TannerCenter for Advanced Surgical Technology, University of Nebraska Medical Center, 986245 Nebraska Medical Center, Omaha, NE, 68198-6246, USA.
Dmitry OleynikovCenter for Advanced Surgical Technology, University of Nebraska Medical Center, 986245 Nebraska Medical Center, Omaha, NE, 68198-6246, USA. doleynik@unmc.edu.ORCID 0000-0002-0656-6596

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundUtilization of laparoscopy (LAP) has been increasing in general surgery for years, and there is currently a rapid increase in the utilization of robotic-assisted surgeries (RAS). This study evaluates trends in the surgical approach utilized in some commonly performed surgeries, the proportion of each approach within the procedures, and the cost of these surgeries based on the surgical approach.

methodsThis is a retrospective study using the Vizient database. The database was queried using ICD-9 codes for colectomy, cholecystectomy, inguinal and ventral hernia repairs, and bariatric surgeries, either open, LAP, or robotically performed. Utilization trends were evaluated between quarters, over a 7-year period, and direct cost was compared between approaches. IBM SPSS v.23.0.0 was used for data analysis, with α = 0.05.

results857,468 patients underwent colectomy, cholecystectomy, inguinal and ventral hernia repairs, and bariatric procedures. A significant decrease in open-approach utilization was seen in colectomy (71.8-61.9%), cholecystectomy (35.7-27.1%), and bariatric surgeries (20.1-10.1%), whereas both LAP and RAS utilization increased (p < 0.001). Significant RAS increase was seen in all five procedures: colectomy (0.4-8.0%), cholecystectomy (0.2-1.8%), IHR (19.9-29.4%), VHR (0.2-2.9%), and bariatric (0.6-5.4%), compared to a decrease in LAP (p < 0.001). Surgery cost was significantly higher for open ($14,364), followed by RAS ($11,376) and LAP ($7945), p < 0.001.

conclusionsRobotic technology is commonly viewed as enabling open procedures to be converted to minimally invasive, a trend not observed in our study. Our trends analysis revealed significant RAS utilization increase from LAP procedures and not from open procedure conversion, although specific surgeon data were not available. RAS were costlier than LAP for all five procedures. The benefits of rapid robot adoption and the forces that are driving these must be examined against a backdrop of burdening an already expensive healthcare system.

Indexed as

AdultDatabases, FactualHealth Care CostsHumansLaparoscopyPractice Patterns, Physicians'Procedures and Techniques UtilizationRetrospective StudiesRobotic Surgical ProceduresUnited StatesBariatric surgeryCostHerniaMinimally invasive surgeryRobotic surgeryTrends

Identifiers

PMID29067582

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.